Navigating the role of clinician-researcher: Insights from a Constructivist Grounded Theory study in traumatic brain injury

Using the case of traumatic brain injury, this paper explores 1) challenges to academic and ethical integrity when in the role of clinician-researcher, and 2) potential strategies to enhance ethical qualitative research involving people with possible physical and/or emotional trauma and temporary or permanent cognitive disruption. When undertaking qualitative research with patients, families, and/ or health professionals, a researcher’s clinical background may stimulate insightful and relevant research questions, interviews, and/or field observations of care to inform meaningful and translatable practice improvements. However, there may be tension between clinician versus researcher values, and these priorities affect what the clinician sees and interprets in the field. A clinician’s ingrained values and professional socialisation can make it difficult to hold their professional assumptions about various phenomena at bay. The principles of human research merit and integrity, justice, beneficence, and respect, along with methodological clarity, can provide a rigorous foundation for discussion of ethical research in traumatic brain injury.

This paper discusses challenges and strategies through: 1) examining clinical assumptions; 2) determining capacity for consent; 3) considering dependent or unequal power relationships; 4) determining the scope for field observations; 5) responding to unprofessional practice; 6) discriminating between research interviews and clinical conversations; and 7) critically reflecting on research data. Implications for clinical research are evident: seeing past one’s own construct of understanding is challenging for clinician-researchers aiming to illuminate both patient and family experiences of care, and nuanced clinical skills. Careful ethical and methodological planning can protect participants while illuminating elements of specialist practice.